Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2014-06-28-7306564

Project Information

Project IdentifiersProject ID: 209511
DEA: 080Q7403
EFIS: 0800020456
DIST-CO-RTE-PM08-SBD-15-15.4/30.8
Award Date10/29/2013
Closeout DateNot set
Work DescriptionDesign Build project provides pavement rehabilitation (including ramps) on I-15 near Cajon Pass, CA.
Location DescriptionOn I-15 from 0.4 mile north of Kenwood Avenue to 0.3 mile south of West Hesperia OH
QA Service Level1 (Verified on 04/03/2014)

Sample Information

Sample Taken Date06/28/2014 Sample Unique Key7306564
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing06/30/2014
Sample typePer Request A brief description of the sampleSoil
The quantity of what the sample constitutes2 Bags From where was the sample collectedSource
First name of sampler or witnessed byJohn Last name of sampler or witnessed byBarrett
Title of samplerNot set Telephone number of samplerNot set
Laboratory sample identification4178B Linked DIME Sample IDNot set
The fabricator/manufacturer/facility nameSBd - 15 - PM 28.70 - S/B Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeSoil The fabricator's/manufacturer's product name for the sampleNot set
The fabricator/manufacturer designation for the sampleNot set A detailed description of where the material sample was collectedSBd - 15 - PM 28.70 - S/B
Where the material sample would have been placed if not sampledNot set

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